Archives of physical medicine and rehabilitation · 2010
Effects of walking with a shopping trolley on spinal posture and loading in subjects with neurogenic claudication.
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Comer Christine M, White Derrick, Conaghan Philip G, Bird Howard A, Redmond Anthony C
Аннотация
OBJECTIVES: To explore possible mechanisms underpinning symptom relief and improved walking tolerance in patients with neurogenic claudication (NC) when pushing a shopping trolley by evaluating the effects of a shopping trolley on spinal posture and loading patterns.
DESIGN: An exploratory study of kinematic and kinetic changes in walking with and without pushing a shopping trolley in persons with NC symptoms and a comparison with asymptomatic control subjects.
SETTING: A primary care-based musculoskeletal service.
PARTICIPANTS: Participants (n=8) with NC symptoms who have anecdotally reported symptomatic improvement when walking with a shopping trolley and a control group of asymptomatic persons (n=8).
INTERVENTIONS: Shopping trolley.
MAIN OUTCOME MEASURES: Changes in lumbar spinal sagittal posture and ground reaction force.
RESULTS: Subjects with NC and asymptomatic controls walked with significantly more flexed spinal posture (increase in flexion, 3.40°; z=3.516; P<.001) and reduced mean ground reaction forces (-6.9% of body weight; z=-3.46; P=.001) when walking with a shopping trolley. However, at the midstance point of the gait cycle, controls showed minimal reliance on the trolley, whereas, people with NC showed continued offloading.
CONCLUSIONS: Both posture and loading are affected by pushing a shopping trolley; however, patients with NC were found to offload the spine throughout the stance phase of gait, whereas asymptomatic controls did not.
DESIGN: An exploratory study of kinematic and kinetic changes in walking with and without pushing a shopping trolley in persons with NC symptoms and a comparison with asymptomatic control subjects.
SETTING: A primary care-based musculoskeletal service.
PARTICIPANTS: Participants (n=8) with NC symptoms who have anecdotally reported symptomatic improvement when walking with a shopping trolley and a control group of asymptomatic persons (n=8).
INTERVENTIONS: Shopping trolley.
MAIN OUTCOME MEASURES: Changes in lumbar spinal sagittal posture and ground reaction force.
RESULTS: Subjects with NC and asymptomatic controls walked with significantly more flexed spinal posture (increase in flexion, 3.40°; z=3.516; P<.001) and reduced mean ground reaction forces (-6.9% of body weight; z=-3.46; P=.001) when walking with a shopping trolley. However, at the midstance point of the gait cycle, controls showed minimal reliance on the trolley, whereas, people with NC showed continued offloading.
CONCLUSIONS: Both posture and loading are affected by pushing a shopping trolley; however, patients with NC were found to offload the spine throughout the stance phase of gait, whereas asymptomatic controls did not.